Article
Management of severe community-acquired pneumonia: a survey on the attitudes of 468 physicians in Iberia and South America
Registro en:
SALLUH, Jorge Ibrain Figueira et al. Management of severe community-acquired pneumonia: a survey on the attitudes of 468 physicians in Iberia and South America. Journal of Critical Care, v.29, n.5, p.743–747, 2014.
0883-9441
10.1016/j.jcrc.2014.05.019
1557-8615
Autor
Salluh, Jorge Ibrain Figueira
Lisboa, Thiago
Bozza, Fernando Augusto
Soares, Márcio
Póvoa, Pedro
Resumen
Purpose: The purpose of this study is to characterize the practices of pulmonary, internal medicine, and critical
care physicians toward the management of patients with severe community-acquired pneumonia (CAP).
Materials and methods: A cross-sectional international anonymous survey was conducted among a
convenience sample of critical care, pulmonary, emergency, and internal medicine physicians from Portugal,
Spain, and South America between October and December 2008. The electronic survey evaluated physicians’
attitudes toward diagnosis, risk assessment, and therapeutic interventions for patients with severe CAP.
Results: Four hundred sixty-eight physicians responded being 84.6% from 4 countries (Brazil, Portugal, Spain,
and Argentina) whom 66.9% had more than 10 years experience. Risk assessment of severe CAP was very
heterogeneous being clinical evaluation the most frequent. Although blood cultures were recognized as
presenting a poor diagnostic performance, they were performed by 77.1%. In opposition, the presence of
urinary pneumococcal and Legionella antigen was asked by less than one-third of physicians. The great
majority (95%) prescribes antibiotics according to a guideline being the combination of β-lactam plus
macrolide the most frequent choice.
Conclusions: Despite the recent advances of knowledge reflected in the present study in the management of
severe CAP, several of themare still incompletely translated into clinical practice. Significant variation in practice
is observedamong physicians and represents a potential target for future research and educational interventions.